NPI | 1285004051 |
---|---|
Former Name | VIRGINIA ELISABETH MINEHART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005114) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005114) |
Enumeration Date | 2015-10-05 |
Last Update Date | 2019-08-27 |