NPI | 1457608853 |
---|---|
Former Name | ASHLEY RICHARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX PA07926) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07926) |
Enumeration Date | 2012-08-06 |
Last Update Date | 2018-10-30 |