NPI | 1669472312 |
---|---|
Former Name | CATHERINE ALEXANDRA GARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001460) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000540A) |
363AS0400X Physician Assistant, Surgical (Licence: WI 2684-023) | |
Enumeration Date | 2005-07-22 |
Last Update Date | 2021-12-17 |