| NPI | 1487810610 |
|---|---|
| Former Name | TABETHA BROOME RAGIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 05414) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2022-04-13 |