NPI | 1376190009 |
---|---|
Former Name | TAYLOR ELIZABETH ROUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07405) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: MD C07405) | |
Enumeration Date | 2019-08-19 |
Last Update Date | 2021-05-24 |