NPI | 1528150927 |
---|---|
Former Name | SUSAN E SMALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003480) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10003480) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2024-03-07 |