| NPI | 1801402888 |
|---|---|
| Former Name | MEREDITH GAINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9935) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 9935) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2023-12-05 |