| NPI | 1891811311 |
|---|---|
| Former Name | LILLIAN S. STANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA00332) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA00332) | |
| 363A00000X Physician Assistant (Licence: WA PA10005191) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-11-14 |