| NPI | 1790187441 | 
|---|---|
| Former Name | MOLLIE E BASH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1636) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1636) | 
| 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000969) | |
| Enumeration Date | 2014-09-24 | 
| Last Update Date | 2025-10-15 |