| NPI | 1154895647 |
|---|---|
| Former Name | CATHERINE WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14997) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113215) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2023-07-07 |