NPI | 1770178857 |
---|---|
Former Name | CAROLINE HARMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA222276) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10506) |
363A00000X Physician Assistant (Licence: WA PA.61521732) | |
Enumeration Date | 2021-03-01 |
Last Update Date | 2024-10-30 |