NPI | 1164794046 |
---|---|
Former Name | LINDSEY M GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2112) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2012-02-07 |
Last Update Date | 2023-09-13 |