| NPI | 1619356946 |
|---|---|
| Former Name | MEGAN ELIZABETH CANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 112032) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 363AM0700X Physician Assistant Medical (Licence: IA 112032) | |
| 363AS0400X Physician Assistant Surgical (Licence: IA 112032) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-03-17 |