NPI | 1770965675 |
---|---|
Former Name | DENA RAE HERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09876) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2015-06-26 |
Last Update Date | 2021-11-10 |