| NPI | 1770864134 |
|---|---|
| Former Name | ANNY HICKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA TEMP License) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA07470) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2021-02-08 |