NPI | 1164603791 |
---|---|
Former Name | JANICE YATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052004) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60056456) |
Enumeration Date | 2007-11-26 |
Last Update Date | 2012-05-29 |