NPI | 1588068902 |
---|---|
Former Name | MAURA T MONAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008327) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3456-23) |
Enumeration Date | 2014-10-14 |
Last Update Date | 2024-02-06 |