NPI | 1992356620 |
---|---|
Former Name | ALEXIS TAYLOR GOLEMO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9112571) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9112571) |
Enumeration Date | 2019-09-24 |
Last Update Date | 2021-08-31 |