| NPI | 1306008065 |
|---|---|
| Former Name | ERIKA ALYSE FUNDERBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06990) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005185) |
| 363A00000X Physician Assistant (Licence: HI AMD-933) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-06-21 |