NPI | 1316074735 |
---|---|
Former Name | HIATT G TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003091RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WV 01281) |
363AM0700X Physician Assistant, Medical (Licence: NY 010956) | |
Enumeration Date | 2007-02-27 |
Last Update Date | 2021-01-20 |