NPI | 1942537493 |
---|---|
Former Name | JODI LEIGH DAIGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60057919) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53663) |
363AM0700X Physician Assistant Medical (Licence: WA PA60057919) | |
Enumeration Date | 2009-11-04 |
Last Update Date | 2019-07-03 |