| NPI | 1093882532 |
|---|---|
| Former Name | LATOYA BRENEKA GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06340) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2018-07-12 |