NPI | 1962997650 |
---|---|
Former Name | CHELSEA LYNN CALLAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117653) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX PA11842) |
363A00000X Physician Assistant (Licence: ND PAC0860) | |
Enumeration Date | 2018-06-26 |
Last Update Date | 2023-10-06 |