NPI | 1942523600 |
---|---|
Former Name | KENDRA M DEWEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106918) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005799) |
Enumeration Date | 2010-03-10 |
Last Update Date | 2020-03-12 |