NPI | 1588102479 |
---|---|
Former Name | EMILY READ MANSFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 3189) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008268) |
363AM0700X Physician Assistant, Medical (Licence: TN 3189) | |
Enumeration Date | 2017-02-10 |
Last Update Date | 2019-01-17 |