NPI | 1487108841 |
---|---|
Former Name | ROBIN PHELPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2016016638) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008808) |
Enumeration Date | 2016-08-15 |
Last Update Date | 2018-07-13 |