| NPI | 1548327653 |
|---|---|
| Former Name | MERRY MATHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1857) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 011540) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-07 |