| NPI | 1265092662 |
|---|---|
| Former Name | ELYSIA FRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14746) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA14746) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA14746) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-10-27 |