NPI | 1134631450 |
---|---|
Former Name | MEREDITH RUTH ROLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA PA11653) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-10-26 |
Last Update Date | 2021-09-01 |