NPI | 1477876415 |
---|---|
Former Name | MEGHAN C BLASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010007131) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2010-03-04 |
Last Update Date | 2025-08-19 |