NPI | 1942586771 |
---|---|
Former Name | LIZBETH GASTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106466) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2216) |
Enumeration Date | 2011-10-25 |
Last Update Date | 2021-07-09 |