| NPI | 1023084019 |
|---|---|
| Former Name | ANDREA DRAKE DRAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 5109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000860) |
| 363A00000X Physician Assistant (Licence: PA MA051040) | |
| 363A00000X Physician Assistant (Licence: TN 5109) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA051040) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA003670) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-08-01 |