| NPI | 1093225161 |
|---|---|
| Former Name | MEGAN MCNICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003909A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006337) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-10-02 |