NPI | 1760989859 |
---|---|
Former Name | ERICA LEIGH CARPENTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WY PA853) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55430) |
Enumeration Date | 2018-04-06 |
Last Update Date | 2022-10-26 |