NPI | 1801556212 |
---|---|
Former Name | KAYLEA A CHRISMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063096) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063096) |
Enumeration Date | 2021-12-27 |
Last Update Date | 2023-11-17 |