NPI | 1437400520 |
---|---|
Former Name | AUDREY ADAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.006983) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-004490) |
Enumeration Date | 2012-09-28 |
Last Update Date | 2022-09-12 |