| NPI | 1801421870 |
|---|---|
| Former Name | MACY TIATTI HEPA-CYR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 171000000X Military Health Care Provider (Licence: TX 1174419) | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2023-08-28 |