NPI | 1518511393 |
---|---|
Former Name | PATRICIA D STAFFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12950) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX PA12950) |
Enumeration Date | 2019-07-30 |
Last Update Date | 2023-06-27 |