NPI | 1427430388 |
---|---|
Former Name | MEAGAN POTRATZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018763) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-06-26 |
Last Update Date | 2021-07-13 |