NPI | 1962948679 |
---|---|
Former Name | CAMERON PAIGE GOBBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11369) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2685) |
Enumeration Date | 2017-01-19 |
Last Update Date | 2023-08-10 |