NPI | 1396977179 |
---|---|
Former Name | MOLLY E GORMLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0030981) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0031059) |
363A00000X Physician Assistant (Licence: VT 055-0031058) | |
Enumeration Date | 2009-08-13 |
Last Update Date | 2019-11-12 |