NPI | 1659313336 |
---|---|
Former Name | MINDI LYN MORGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004770) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104369) |
363AM0700X Physician Assistant, Medical (Licence: CT 001618) | |
Enumeration Date | 2006-06-10 |
Last Update Date | 2019-02-18 |