NPI | 1013215060 |
---|---|
Former Name | EMILY SUZANNE TERRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21459) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21459) |
Enumeration Date | 2011-02-28 |
Last Update Date | 2016-11-10 |