| NPI | 1609989631 |
|---|---|
| Former Name | GWYNN BUCHANAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051398) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA000920) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-04-28 |