NPI | 1821405473 |
---|---|
Former Name | JO LISA ASHLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1890) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2014-07-15 |
Last Update Date | 2024-12-09 |