NPI | 1790957496 |
---|---|
Former Name | DEBBY YOHANNAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA 06711) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001958) |
363A00000X Physician Assistant (Licence: NY 011589) | |
Enumeration Date | 2008-04-02 |
Last Update Date | 2015-08-18 |