NPI | 1609327816 |
---|---|
Former Name | MADELYN MCNAMARA SCRENOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109804) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109804) |
Enumeration Date | 2016-10-23 |
Last Update Date | 2023-04-12 |