NPI | 1245648963 |
---|---|
Former Name | JAMIE EMERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005163) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 074483) |
Enumeration Date | 2014-07-25 |
Last Update Date | 2014-09-04 |