| NPI | 1750687661 |
|---|---|
| Former Name | MEGAN E. BERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI CPA00657) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 2719-23) | |
| 363AM0700X Physician Assistant, Medical (Licence: RI CPA00657) | |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2023-02-28 |