| NPI | 1811751803 |
|---|---|
| Former Name | ELIZABETH CHRISTINE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2024-02-09 |