NPI | 1932675600 |
---|---|
Former Name | ASHELY SUTTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58252) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006696) |
363AS0400X Physician Assistant, Surgical (Licence: CA PA58252) | |
Enumeration Date | 2018-10-19 |
Last Update Date | 2024-09-04 |