| NPI | 1972653160 |
|---|---|
| Former Name | DIANA K MAXWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105415) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 00517) |
| 363A00000X Physician Assistant (Licence: FL PA9105415) | |
| 363A00000X Physician Assistant (Licence: OH 50000868) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WV 517) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50000868) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2021-03-11 |