NPI | 1578956231 |
---|---|
Former Name | MOLLY K. FORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3482-23) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-03-05 |
Last Update Date | 2021-04-06 |