NPI | 1902039654 |
---|---|
Former Name | ASHLEY B LONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01966) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01966) |
Enumeration Date | 2009-08-28 |
Last Update Date | 2020-10-25 |