NPI | 1427325638 |
---|---|
Former Name | JEANETTE C. ALCORN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5411) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001343A) |
Enumeration Date | 2011-11-17 |
Last Update Date | 2022-07-21 |