NPI | 1760017461 |
---|---|
Former Name | ALISON BEVERLY AUSTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013266) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-981) |
Enumeration Date | 2020-03-03 |
Last Update Date | 2025-08-12 |