NPI | 1457724403 |
---|---|
Former Name | MAVANY CAFFREY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109290) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA53260) |
Enumeration Date | 2015-11-12 |
Last Update Date | 2019-08-28 |