NPI | 1174870117 |
---|---|
Former Name | ELIZABETH ANN BRISCOE BOWER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA0902) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015848) |
Enumeration Date | 2012-08-09 |
Last Update Date | 2016-04-12 |