NPI | 1790279479 |
---|---|
Other Name | JOE KENNEDY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-06-18 |
Last Update Date | 2024-10-15 |