NPI | 1992362305 |
---|---|
Former Name | KELLY DIANA KNEPPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006713) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08695) |
Enumeration Date | 2019-05-21 |
Last Update Date | 2024-05-24 |