NPI | 1356823272 |
---|---|
Former Name | ALLISON MICHELLE BURCKHARTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10147) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12293) |
Enumeration Date | 2018-09-06 |
Last Update Date | 2019-02-08 |