| NPI | 1477796217 |
|---|---|
| Former Name | MIRANDA L WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 2992) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.002889) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 6038) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2018-08-06 |