NPI | 1396328837 |
---|---|
Former Name | MEGAN MIANO CRAFT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2843) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA2843) |
363AM0700X Physician Assistant, Medical (Licence: KY PA2843) | |
Enumeration Date | 2021-05-03 |
Last Update Date | 2023-12-19 |