NPI | 1063749141 |
---|---|
Former Name | MEGAN R ODEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008200) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 085003616) |
363A00000X Physician Assistant (Licence: DC PA031506) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2009-11-10 |
Last Update Date | 2021-12-22 |