NPI | 1073002804 |
---|---|
Former Name | MEGAN BUTLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009208RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059749) |
Enumeration Date | 2018-05-07 |
Last Update Date | 2025-07-09 |