NPI | 1891205365 |
---|---|
Former Name | CAITLIN EMILY BOOHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 6920) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6920) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2022-12-15 |