NPI | 1174094999 |
---|---|
Former Name | MONIKA MCCOWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2414) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA2414) |
363AS0400X Physician Assistant, Surgical (Licence: KY PA2414) | |
Enumeration Date | 2018-12-06 |
Last Update Date | 2024-09-04 |