NPI | 1437232949 |
---|---|
Former Name | MARY ELIZABETH HISATOMI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C000333) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3345) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2020-11-30 |