NPI | 1154575561 |
---|---|
Former Name | SUSAN E PARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07373) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1675) |
Enumeration Date | 2008-11-12 |
Last Update Date | 2023-05-05 |