NPI | 1902243298 |
---|---|
Former Name | CAMILLE NICOLE COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22984) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8512355-1206) |
363A00000X Physician Assistant (Licence: PA MA056088) | |
Enumeration Date | 2013-05-28 |
Last Update Date | 2022-12-06 |