NPI | 1770168239 |
---|---|
Former Name | CASSIDY MULL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10003976B) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-03-16 |
Last Update Date | 2023-09-05 |