NPI | 1225409485 |
---|---|
Former Name | ANTONIA M GARLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3951) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005534) |
Enumeration Date | 2015-10-14 |
Last Update Date | 2021-04-02 |