NPI | 1174903447 |
---|---|
Former Name | ERIKA L PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 007606) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006639) |
Enumeration Date | 2015-06-02 |
Last Update Date | 2021-01-08 |