NPI | 1811137607 |
---|---|
Former Name | MEGAN K STOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA152616) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-03-06 |
Last Update Date | 2022-11-02 |