| NPI | 1215265681 |
|---|---|
| Former Name | ALICIA MOHAMMED |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 5750) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2020-08-27 |