| NPI | 1457074775 |
|---|---|
| Former Name | ANDREA TIMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2023-12-29 |