NPI | 1649321837 |
---|---|
Former Name | CHRISTINA A. BLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3399) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 3399) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2016-07-14 |