| NPI | 1679002638 |
|---|---|
| Former Name | MARIAH ANNE LUNDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059134) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059134) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2024-08-29 |