| NPI | 1528577343 |
|---|---|
| Former Name | MEGAN RENEE FARRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59581) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1526) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2024-10-14 |