NPI | 1184745697 |
---|---|
Former Name | MAROLYN JEAN BOWMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1936) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 1045922) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2011-02-01 |