NPI | 1780833749 |
---|---|
Former Name | JAMIE MARIE WIMSATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1146) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY TC045) |
Enumeration Date | 2008-09-15 |
Last Update Date | 2016-10-18 |