NPI | 1649786781 |
---|---|
Former Name | ERICA A MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9110977) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-12-27 |
Last Update Date | 2025-05-01 |