NPI | 1992181358 |
---|---|
Former Name | COURTNEY JONES BOWLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA17511) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 7666) |
Enumeration Date | 2015-08-07 |
Last Update Date | 2024-02-26 |