NPI | 1346719093 |
---|---|
Former Name | MEGAN E. GALLMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 4579) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4579-23) |
Enumeration Date | 2018-11-23 |
Last Update Date | 2021-05-05 |