NPI | 1063632255 |
---|---|
Former Name | PATRICIA HUBBARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107809) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1522) |
Enumeration Date | 2007-04-27 |
Last Update Date | 2023-09-05 |