NPI | 1861743569 |
---|---|
Former Name | PROMISE GOLDYN TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 5036) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0033) |
363A00000X Physician Assistant (Licence: TN 5036) | |
363AS0400X Physician Assistant, Surgical (Licence: NM PA2012-0033) | |
Enumeration Date | 2012-09-21 |
Last Update Date | 2023-03-08 |