NPI | 1831592484 |
---|---|
Former Name | CARTER ELLIS WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05858) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60507197) |
Enumeration Date | 2014-09-26 |
Last Update Date | 2017-01-23 |