| NPI | 1659775906 |
|---|---|
| Former Name | NATALIE REAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 2655) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2016-05-26 |