NPI | 1194192732 |
---|---|
Former Name | LEAH MARIE WADKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 8780) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 8780) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2015-08-31 |
Last Update Date | 2018-07-26 |