NPI | 1427152479 |
---|---|
Former Name | LISA SMITH VEALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03829) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09564) |
363A00000X Physician Assistant (Licence: MD C07519) | |
363A00000X Physician Assistant (Licence: VA 0110-006975) | |
Enumeration Date | 2006-09-12 |
Last Update Date | 2020-04-14 |