| NPI | 1831832120 |
|---|---|
| Former Name | ELIZABETH RUTH MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008586) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2023-09-22 |