NPI | 1023071156 |
---|---|
Former Name | SANDRA KAY GONZALEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 989) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1500323) |
363A00000X Physician Assistant (Licence: KS 15-00323) | |
Enumeration Date | 2006-04-10 |
Last Update Date | 2011-11-04 |