| NPI | 1043233257 |
|---|---|
| Former Name | DEANNA WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3585) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO 2249) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-10-15 |