| NPI | 1437462942 |
|---|---|
| Former Name | ELIZABETH KAY WALCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054411) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2016-03-11 |