NPI | 1790025302 |
---|---|
Former Name | ASHLEY RENEE DODSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 2303) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2303) |
Enumeration Date | 2013-02-19 |
Last Update Date | 2020-06-24 |