| NPI | 1598151177 |
|---|---|
| Former Name | ALLIE DUKE BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108675) |
| 363A00000X Physician Assistant (Licence: SC 2733) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2018-06-13 |