NPI | 1285061614 |
---|---|
Former Name | CLARICE A TWITTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60418621) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60418621) |
Enumeration Date | 2013-09-30 |
Last Update Date | 2019-09-30 |