NPI | 1417223629 |
---|---|
Former Name | MEGAN JEFFORDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA180927) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA 1020398) |
Enumeration Date | 2012-04-02 |
Last Update Date | 2019-06-28 |