| NPI | 1972951432 |
|---|---|
| Former Name | CAMILLE L PREVOST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 0550031699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5721) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2023-08-30 |