NPI | 1235479064 |
---|---|
Former Name | ERIN C TIERNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002310A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107018) |
Enumeration Date | 2013-02-14 |
Last Update Date | 2022-03-18 |