NPI | 1164572418 |
---|---|
Former Name | MARISSA R NEWTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA2241) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 2241) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2017-04-12 |