NPI | 1467654517 |
---|---|
Former Name | AUTUMN HAMADY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004068) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2015-08-28 |