NPI | 1184245151 |
---|---|
Former Name | CHELSEY MARIE MAHONEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA207251) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-30 |
Last Update Date | 2024-06-24 |