NPI | 1215922620 |
---|---|
Former Name | JOANN GAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10000363A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000363A) |
Enumeration Date | 2005-09-13 |
Last Update Date | 2024-04-26 |