| NPI | 1306147905 |
|---|---|
| Former Name | TERI LYNN FITZGERALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4707) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4707) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 4707) | |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2020-02-19 |