NPI | 1124219233 |
---|---|
Former Name | ELIZABETH C NETHERCOTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3946) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052922) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2015-07-08 |