NPI | 1841661972 |
---|---|
Former Name | OLIVIA P WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001911A) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: IN 10001911A) |
Enumeration Date | 2015-10-15 |
Last Update Date | 2022-05-23 |