NPI | 1174172316 |
---|---|
Former Name | AHJAINENE TIAHNA HAMILTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA196245) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004016A) |
Enumeration Date | 2019-09-10 |
Last Update Date | 2023-11-29 |