NPI | 1124029822 |
---|---|
Former Name | TRESHELL RAMBOUT GREENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102226) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 102226) |
Enumeration Date | 2005-08-03 |
Last Update Date | 2023-04-20 |