NPI | 1952708695 |
---|---|
Former Name | EMILY E. WYNNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57548) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09710) |
Enumeration Date | 2014-11-24 |
Last Update Date | 2019-11-25 |