| NPI | 1720416431 |
|---|---|
| Former Name | MEGAN T. LUCIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2015-0013) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 165097) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2017-01-11 |