NPI | 1336164656 |
---|---|
Former Name | MISTY M WRIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2308) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 2308) |
363AS0400X Physician Assistant, Surgical (Licence: AZ 2308) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2022-12-19 |