| NPI | 1588693196 |
|---|---|
| Former Name | MARCELLA DAWN DICKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000454A) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000454A) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-03-15 |