NPI | 1861965048 |
---|---|
Former Name | TAYLOR ALLYSON GREGORY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008859) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112229) |
363A00000X Physician Assistant (Licence: FL PA9112229) | |
Enumeration Date | 2019-01-09 |
Last Update Date | 2024-11-06 |