NPI | 1942553268 |
---|---|
Former Name | KALI RICHARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA171510) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22594) |
363A00000X Physician Assistant (Licence: WA PA60319909) | |
Enumeration Date | 2012-10-24 |
Last Update Date | 2019-06-12 |