NPI | 1396366035 |
---|---|
Former Name | ANNA K OMALLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4277) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 4277) |
Enumeration Date | 2020-05-05 |
Last Update Date | 2023-03-01 |