NPI | 1295886356 |
---|---|
Former Name | CYNTHIA A GEORGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085000582) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 085000582) |
Enumeration Date | 2007-01-16 |
Last Update Date | 2018-06-29 |