NPI | 1770991051 |
---|---|
Former Name | CORI WINIFRED SINNOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064113) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126002156) |
363AM0700X Physician Assistant, Medical (Licence: PA MA064113) | |
363AS0400X Physician Assistant, Surgical (Licence: PA MA064113) | |
Enumeration Date | 2014-07-30 |
Last Update Date | 2022-11-28 |