| NPI | 1417330952 |
|---|---|
| Former Name | MEGAN CIERA LOUCKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58233) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2023-05-10 |