NPI | 1033100391 |
---|---|
Former Name | FELICIA C HAWTHORNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C02031) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA30070) |
Enumeration Date | 2005-11-03 |
Last Update Date | 2014-04-10 |