| NPI | 1760734909 |
|---|---|
| Former Name | MAUREEN S ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108753) |
| 363A00000X Physician Assistant (Licence: OH 50.003628) | |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2019-03-01 |