NPI | 1790861896 |
---|---|
Former Name | JAIME RYAN CHANDLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA301) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003208) |
363A00000X Physician Assistant (Licence: ME PA1332) | |
Enumeration Date | 2006-10-31 |
Last Update Date | 2020-07-14 |