NPI | 1639234016 |
---|---|
Former Name | CYNTHIA L GLASGOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 8983549-1206) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 8983549-1206) |
Enumeration Date | 2006-12-26 |
Last Update Date | 2016-06-28 |