NPI | 1730688227 |
---|---|
Former Name | AMELIA R GOVERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13009) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2209) |
Enumeration Date | 2018-02-09 |
Last Update Date | 2025-09-25 |