| NPI | 1790344133 |
|---|---|
| Former Name | ELIZABETH RODGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA A062219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07216) |
| 363A00000X Physician Assistant (Licence: NC 0010-09026) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2022-06-21 |