NPI | 1013950674 |
---|---|
Former Name | TARA ELIZABETH MCERLEAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0003056) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003056) |
363AM0700X Physician Assistant, Medical (Licence: MD C0003056) | |
Enumeration Date | 2006-06-13 |
Last Update Date | 2011-04-06 |