NPI | 1982253654 |
---|---|
Former Name | ALLISON CHILDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7670-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12971) |
Enumeration Date | 2019-09-05 |
Last Update Date | 2024-05-13 |