NPI | 1205373081 |
---|---|
Former Name | MIRANDA LEIGH WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC MPA.5693) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 0010-07076) |
363A00000X Physician Assistant (Licence: NC 0010-07076) | |
363A00000X Physician Assistant (Licence: CO PA.0007445) | |
Enumeration Date | 2017-01-31 |
Last Update Date | 2025-05-07 |