NPI | 1891923793 |
---|---|
Former Name | ISRAEL WHEELER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 2278) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013378) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2019-01-09 |