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Individual
ELIZABETH DANIELS
Active
Individual
ELIZABETH DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4926-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4926-23
STATE OF WISCONSIN LICENSE NUMBER
WI
Enumeration date
11/07/2019
Last updated
12/01/2021
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