NPI | 1811145873 |
---|---|
Former Name | KASSIA ROSE KNUDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08840) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002798) |
Enumeration Date | 2008-09-03 |
Last Update Date | 2015-12-10 |