| NPI | 1639726656 |
|---|---|
| Former Name | ASHLEY V GAVIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1173669) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2023-09-22 |