NPI | 1790709806 |
---|---|
Former Name | STACIE LYNN HILL-LUTTRELL-SPEAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04487) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2021-03-12 |