NPI | 1922280734 |
---|---|
Former Name | BRENDA JOYCE KRALOVETZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02265) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: TX PA02265) |
Enumeration Date | 2007-12-04 |
Last Update Date | 2007-12-04 |