| NPI | 1083171375 |
|---|---|
| Former Name | MARY MORHARDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7416) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 7416) |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2021-11-03 |