NPI | 1679771604 |
---|---|
Former Name | DEVONY A WEBSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 756) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 00756) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2025-01-02 |