| NPI | 1528193802 |
|---|---|
| Former Name | TRACI ALICE FEATHERSTONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05225) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: UT 6482385-8906) |
| 363AM0700X Physician Assistant Medical (Licence: UT 6482385-1206) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2018-03-17 |