NPI | 1912928847 |
---|---|
Former Name | SUZANNE CHRISTINE GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051476) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: WA 10005060) | |
Enumeration Date | 2006-07-23 |
Last Update Date | 2022-07-21 |