NPI | 1699263962 |
---|---|
Former Name | TAYLOR ANN WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111004) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: TX PA12004) | |
Enumeration Date | 2018-04-23 |
Last Update Date | 2023-07-12 |