NPI | 1386129724 |
---|---|
Former Name | HANNAH JOY GRAVITT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9059) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8113) |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-01-18 |