NPI | 1255924643 |
---|---|
Former Name | CATERINA ELLIOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012389) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601012389) |
363A00000X Physician Assistant (Licence: IN 10003368A) | |
Enumeration Date | 2021-02-16 |
Last Update Date | 2025-09-03 |