NPI | 1649775412 |
---|---|
Former Name | BELLAMY CLARISSA HAWKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.1325) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA.1325) |
Enumeration Date | 2018-03-26 |
Last Update Date | 2020-01-23 |