NPI | 1356628747 |
---|---|
Former Name | MARLECIA LANEI HOLLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006494) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: MD C0004576) |
363AM0700X Physician Assistant, Medical (Licence: MD C0004576) | |
Enumeration Date | 2011-11-14 |
Last Update Date | 2022-05-06 |