NPI | 1982055869 |
---|---|
Former Name | MARY MUNOZ DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12621) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 302074) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2023-04-26 |