| NPI | 1790563211 |
|---|---|
| Former Name | MARY ALEXIS HALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13667) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-07-29 |