NPI | 1114178282 |
---|---|
Former Name | WENDY ANN THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4195) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 00180553) |
363A00000X Physician Assistant (Licence: OH 50.003768) | |
Enumeration Date | 2008-10-07 |
Last Update Date | 2017-03-10 |