NPI | 1982911558 |
---|---|
Former Name | TIMESHA J. WIMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010148) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4682) |
Enumeration Date | 2010-09-02 |
Last Update Date | 2025-09-08 |