NPI | 1992001465 |
---|---|
Former Name | COURTNEY E BOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL1621) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1621) |
Enumeration Date | 2011-02-01 |
Last Update Date | 2021-11-03 |