NPI | 1912472424 |
---|---|
Former Name | JACQUELINE N MCWHORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0006559) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002470A) |
Enumeration Date | 2018-10-11 |
Last Update Date | 2024-05-13 |