NPI | 1669529129 |
---|---|
Former Name | LORI LYNN HALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04913) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04913) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2023-07-27 |