NPI | 1770735532 |
---|---|
Former Name | CARLA JOBETH SHELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-445) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AR PA-445) |
363AS0400X Physician Assistant, Surgical (Licence: NC 0010-01506) | |
Enumeration Date | 2008-10-10 |
Last Update Date | 2024-05-30 |