NPI | 1033691670 |
---|---|
Former Name | NATALIE GAIL BURRES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7156) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55908) |
363AS0400X Physician Assistant, Surgical (Licence: CA PA22908) | |
Enumeration Date | 2018-08-30 |
Last Update Date | 2023-01-05 |