| NPI | 1285229609 |
|---|---|
| Former Name | MARY JOSEPHINE BOWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10253) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 10253) |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-07-30 |