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 |