NPI | 1861253791 |
---|---|
Former Name | ANNA BATES SHINER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010267) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2024-01-18 |
Last Update Date | 2024-09-19 |