| NPI | 1811274616 |
|---|---|
| Former Name | CARLY RADCLIFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA055049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055049) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2020-10-05 |