NPI | 1942621628 |
---|---|
Former Name | SHEILA ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-08971) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003845) |
Enumeration Date | 2013-12-23 |
Last Update Date | 2024-11-15 |