NPI | 1114098571 |
---|---|
Former Name | ADRIENNE S EDDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0639P) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001509) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2021-03-10 |