NPI | 1780197673 |
---|---|
Former Name | GABRIELLE C BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002876A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00454900) |
Enumeration Date | 2017-11-14 |
Last Update Date | 2023-01-11 |