NPI | 1992369938 |
---|---|
Former Name | TARYN NICHOLE ASHLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 13032) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13032) |
Enumeration Date | 2019-04-25 |
Last Update Date | 2020-10-09 |