NPI | 1417253204 |
---|---|
Former Name | ROBIN LEAR PEACOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02742) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02742) |
Enumeration Date | 2011-01-27 |
Last Update Date | 2023-05-18 |