| NPI | 1073842696 |
|---|---|
| Former Name | DANIELLE RENE BAGALEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA06461) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06461) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2021-11-01 |