NPI | 1932645884 |
---|---|
Former Name | EMMA LOVE GILMARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 3653) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3653) |
363A00000X Physician Assistant (Licence: NM PA2017-0001) | |
Enumeration Date | 2017-01-17 |
Last Update Date | 2019-02-13 |