NPI | 1760665459 |
---|---|
Former Name | GIA FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL .821) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052202) |
363A00000X Physician Assistant (Licence: GA 006451) | |
Enumeration Date | 2007-12-17 |
Last Update Date | 2018-01-29 |