| NPI | 1114551447 |
|---|---|
| Former Name | EUGENIE WEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-08-27 |