| NPI | 1528196169 |
|---|---|
| Former Name | ELETHEA GEORGE HARE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011229-1) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2018-03-22 |