NPI | 1497178529 |
---|---|
Former Name | AMY OGBONNAYA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10145) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2324) |
Enumeration Date | 2014-01-24 |
Last Update Date | 2019-06-07 |