NPI | 1689138588 |
---|---|
Former Name | TAYLOR RENEA WALKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2020031347) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02366) |
Enumeration Date | 2019-01-24 |
Last Update Date | 2024-09-23 |