NPI | 1669612701 |
---|---|
Former Name | ERIN MICHELLE WALLANDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09309) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001001520) |
363A00000X Physician Assistant (Licence: NV PA1370) | |
Enumeration Date | 2009-03-03 |
Last Update Date | 2016-07-06 |