NPI | 1023275427 |
---|---|
Former Name | RAYLEE S WEAVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60231454) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 102266) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2014-01-23 |