| NPI | 1417022013 |
|---|---|
| Former Name | GWEN S WHITEHEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15930) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA15930) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-01-29 |