| NPI | 1164496212 |
|---|---|
| Former Name | MARY T CARR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001597) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IA 001597) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-12-29 |