NPI | 1467869461 |
---|---|
Former Name | EMILY EDMONDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004602) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 005082) |
Enumeration Date | 2014-07-22 |
Last Update Date | 2018-02-07 |