NPI | 1285022095 |
---|---|
Former Name | JAIMIE LEANNE MCGLOTHLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-004707) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000002664) |
Enumeration Date | 2014-12-31 |
Last Update Date | 2017-02-27 |