NPI | 1154895597 |
---|---|
Former Name | MORGAN PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 56358) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56358) |
363AM0700X Physician Assistant, Medical (Licence: CA 56358) | |
Enumeration Date | 2019-01-18 |
Last Update Date | 2020-10-21 |