| NPI | 1447506407 |
|---|---|
| Former Name | DIANA LEIGH WALTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055424) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA09098) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2023-06-23 |