NPI | 1841810074 |
---|---|
Former Name | ABIGAIL LYNN PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007610) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-17 |
Last Update Date | 2023-02-20 |