NPI | 1770022022 |
---|---|
Former Name | KENDALL ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11063) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2017-02-20 |
Last Update Date | 2020-03-28 |