NPI | 1952950370 |
---|---|
Former Name | PENNY ANN ELDRED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2491) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61120377) |
Enumeration Date | 2019-09-09 |
Last Update Date | 2024-10-29 |