NPI | 1518389857 |
---|---|
Former Name | TERESA D LEWIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7521) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2014-01-06 |
Last Update Date | 2023-10-20 |