NPI | 1093011074 |
---|---|
Former Name | ERIN K MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2046) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005001) |
Enumeration Date | 2011-02-08 |
Last Update Date | 2022-01-19 |