| NPI | 1356539266 |
|---|---|
| Former Name | MARIKO TANSEY HOLBROOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00942) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA2412) |
| 363A00000X Physician Assistant (Licence: TX 08137) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2017-05-08 |