| NPI | 1578021739 |
|---|---|
| Former Name | MALLORY STRONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5006-23) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2020-03-11 |