NPI | 1639450760 |
---|---|
Former Name | MEGHAN LYNN CARR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003765) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055107) |
Enumeration Date | 2011-09-02 |
Last Update Date | 2022-10-26 |