NPI | 1588626915 |
---|---|
Former Name | AMY UPCHURCH FALES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103935) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 103935) |
Enumeration Date | 2006-04-03 |
Last Update Date | 2023-02-03 |