NPI | 1467085746 |
---|---|
Former Name | MERON GIZAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09503) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2020-02-15 |
Last Update Date | 2021-09-07 |