NPI | 1245697002 |
---|---|
Former Name | MEGAN SADAKANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA53111) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA53111) |
363A00000X Physician Assistant (Licence: CA PA53111) | |
Enumeration Date | 2016-01-25 |
Last Update Date | 2021-12-14 |