NPI | 1124472428 |
---|---|
Former Name | AUDREY MCGOWEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15964) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2591) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2023-10-16 |