| NPI | 1992114425 |
|---|---|
| Former Name | CORBIE BALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5779) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5779) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 5779) | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2021-08-13 |