NPI | 1669497152 |
---|---|
Former Name | DENISE MARIE RHOADS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 01252) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052197) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2021-09-23 |