NPI | 1548735228 |
---|---|
Former Name | TARAH E WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12496) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-10-09 |
Last Update Date | 2023-03-14 |