NPI | 1457636755 |
---|---|
Former Name | MILEA EMMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006368rx) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 003566) |
363AS0400X Physician Assistant, Surgical (Licence: NY 015095) | |
Enumeration Date | 2011-10-18 |
Last Update Date | 2020-06-25 |