| NPI | 1306261508 |
|---|---|
| Former Name | GENEVIEVE DAUGHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001526A) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: IN 10001526A) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2019-04-22 |