| NPI | 1063417608 |
|---|---|
| Former Name | FREDA ELLEN SIMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 002766) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 002766) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2007-10-22 |