| NPI | 1841587789 |
|---|---|
| Former Name | JUDITH MARIE CODDINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110005075) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 006132) |
| 363AM0700X Physician Assistant Medical (Licence: MD C0005383) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2015-11-03 |