| NPI | 1720279979 |
|---|---|
| Former Name | MARCIE MARIE ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 01569) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002580) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2018-12-06 |