NPI | 1598093478 |
---|---|
Former Name | MOLLY K PERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007569) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 2861) |
363A00000X Physician Assistant (Licence: MA PA4875) | |
Enumeration Date | 2009-12-03 |
Last Update Date | 2021-01-26 |