NPI | 1649556218 |
---|---|
Former Name | MEGAN MARIE TALBOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003453RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 552) |
363A00000X Physician Assistant (Licence: OH 50.003453) | |
Enumeration Date | 2011-10-27 |
Last Update Date | 2021-10-06 |