| NPI | 1629403423 |
|---|---|
| Former Name | CRYSTAL LEE HALLORAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15093) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2022-07-21 |