| NPI | 1770081788 |
|---|---|
| Former Name | MARY ELIZABETH BARRACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 3545) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 3545) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-03-06 |