NPI | 1336702646 |
---|---|
Former Name | HANNAH AGREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56894) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-22 |
Last Update Date | 2019-08-06 |