NPI | 1164031720 |
---|---|
Former Name | MORGAN TAYLOR LOCKLEAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 001010310) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: NC 001007692) | |
Enumeration Date | 2020-07-29 |
Last Update Date | 2023-08-17 |