| NPI | 1962701920 |
|---|---|
| Former Name | PEGGY DIANA WALSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004293) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07177) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2022-07-27 |