NPI | 1780079608 |
---|---|
Former Name | JEANNA J GARLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07904) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004975) |
Enumeration Date | 2015-03-30 |
Last Update Date | 2018-06-23 |