NPI | 1699108522 |
---|---|
Former Name | RETTA WILLIAMS WEBB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01631) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2013037124) |
Enumeration Date | 2013-08-14 |
Last Update Date | 2018-12-13 |