NPI | 1992163224 |
---|---|
Former Name | SULLIVAN PARKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005994) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006194) |
363AM0700X Physician Assistant, Medical (Licence: OK 2647) | |
Enumeration Date | 2016-02-01 |
Last Update Date | 2023-11-16 |