NPI | 1023368552 |
---|---|
Former Name | ABBY JOANNE WOODWARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055731) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: PA MA055731) | |
Enumeration Date | 2012-09-12 |
Last Update Date | 2018-05-02 |