NPI | 1720590268 |
---|---|
Former Name | VICTORIA BLAIRE FRITCHIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11560) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-10-24 |
Last Update Date | 2019-01-02 |