NPI | 1558914424 |
---|---|
Former Name | TESSA J MCDONALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-07-19 |
Last Update Date | 2023-02-09 |