NPI | 1609989631 |
---|---|
Former Name | GWYNN BUCHANAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051398) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA000920) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2009-04-28 |