| NPI | 1871818229 |
|---|---|
| Former Name | ALLISON RENEE WAITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL 969) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA 60137842) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2015-11-25 |