NPI | 1326351099 |
---|---|
Former Name | MONICA J REARICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 5885) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 5885) |
Enumeration Date | 2010-07-22 |
Last Update Date | 2021-02-23 |