NPI | 1295700425 |
---|---|
Former Name | TERESA DESHAWN DREW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2962) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031082) |
363A00000X Physician Assistant (Licence: MD C0003136) | |
363AM0700X Physician Assistant, Medical (Licence: DE C5-0000491) | |
Enumeration Date | 2006-02-21 |
Last Update Date | 2023-05-31 |