| NPI | 1598814469 |
|---|---|
| Former Name | MARLA FAITH TEAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 004138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004138) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-01-07 |