| NPI | 1336650266 |
|---|---|
| Former Name | MADELINE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6869) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6869) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2021-04-21 |