NPI | 1184249146 |
---|---|
Former Name | TAKARA RAGLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA60134) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60134) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-06-15 |
Last Update Date | 2023-01-25 |