NPI | 1912359647 |
---|---|
Former Name | DEIRDRE RHOADS ZIMMERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4169) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008012) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2022-07-21 |