NPI | 1588736854 |
---|---|
Former Name | JAMIE B ROGERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005242) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA 1462) |
Enumeration Date | 2006-11-14 |
Last Update Date | 2010-07-22 |