NPI | 1255303970 |
---|---|
Former Name | TERESA PHYLLIS FOSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA52284) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 104028) |
Enumeration Date | 2006-02-06 |
Last Update Date | 2023-03-07 |