| NPI | 1518496280 |
|---|---|
| Former Name | MEGAN LEE DEROY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 1003718A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-09-05 |