| NPI | 1083100341 |
|---|---|
| Former Name | MARIAN ALEXA CORCORAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7532) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2009) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2023-08-25 |