NPI | 1104958560 |
---|---|
Former Name | JANICE HALLFORD WILKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03109) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 13264) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2022-04-20 |