| NPI | 1003128547 |
|---|---|
| Former Name | MAEGAN E RISLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054400) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003405) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2016-04-08 |