NPI | 1184076333 |
---|---|
Former Name | ELIZABETH ANN HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA066645) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA53846) |
Enumeration Date | 2016-07-11 |
Last Update Date | 2025-09-05 |