| 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 | 2024-12-17 |