NPI | 1144558669 |
---|---|
Former Name | DONNA FAYE DENTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110009697) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1471) |
Enumeration Date | 2009-11-20 |
Last Update Date | 2024-06-27 |