NPI | 1992338446 |
---|---|
Former Name | ASHLEY KENNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14044) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5089) |
Enumeration Date | 2020-02-12 |
Last Update Date | 2024-02-28 |