NPI | 1467517680 |
---|---|
Former Name | JAIME L HAGERTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002378) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA050775) |
Enumeration Date | 2006-12-27 |
Last Update Date | 2020-09-30 |