| NPI | 1255640074 |
|---|---|
| Former Name | MALLORY K MEEHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10513) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60385985) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2023-11-07 |