NPI | 1457410284 |
---|---|
Former Name | ERIN C DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA1190) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004985) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA10004985) | |
Enumeration Date | 2006-12-07 |
Last Update Date | 2021-12-03 |