NPI | 1588011928 |
---|---|
Former Name | ALICIA JEAN TIGGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1516) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-05-16 |
Last Update Date | 2020-02-24 |