NPI | 1205188349 |
---|---|
Other Name | TANIS MCCOWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063270) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C-50000844) |
Enumeration Date | 2012-10-14 |
Last Update Date | 2022-03-14 |