NPI | 1528541083 |
---|---|
Former Name | ELIZABETH ANN GILLOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060093) |
Additional Taxonomies | 208600000X Surgery (Licence: PA OA004602) |
Enumeration Date | 2018-09-11 |
Last Update Date | 2022-10-28 |