NPI | 1881148005 |
---|---|
Former Name | KALI SHEPHARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0748) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005909) |
Enumeration Date | 2016-08-04 |
Last Update Date | 2019-01-21 |