NPI | 1184860694 |
---|---|
Former Name | ANNA CHRISTINE ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12707) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50004725RX) |
363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12707) | |
Enumeration Date | 2009-01-05 |
Last Update Date | 2022-12-15 |