NPI | 1417960048 |
---|---|
Former Name | ELIZABETH A GLYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06182) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002291) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2012-04-30 |