| NPI | 1245501501 |
|---|---|
| Former Name | ELIZABETH ANN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA164212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8154350-1206) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2021-02-16 |