NPI | 1982225744 |
---|---|
Former Name | COURTNEY LYNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14450) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 100059) |
Enumeration Date | 2020-05-04 |
Last Update Date | 2023-08-28 |