| NPI | 1114345089 |
|---|---|
| Former Name | VICTORIA ELIZABETH LORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 008635) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA08985) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2022-05-02 |