| NPI | 1689729683 |
|---|---|
| Former Name | REENA WYATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02642) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-09-23 |