| NPI | 1457127144 |
|---|---|
| Former Name | MARY CLAIRE BASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004199A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-14 |