NPI | 1184677536 |
---|---|
Former Name | TAMMIE S WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 96) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA-96) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2019-05-14 |