NPI | 1629332911 |
---|---|
Former Name | LEDY P DAVIDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2295) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: SC 2295) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2023-07-28 |