NPI | 1184918914 |
---|---|
Former Name | MEGAN ASHLEY RIVIERE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2760-23) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2760-23) |
Enumeration Date | 2011-06-09 |
Last Update Date | 2022-07-27 |