NPI | 1811950330 |
---|---|
Former Name | MARY FRANCES HANLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106543) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA002458L) |
Enumeration Date | 2006-04-07 |
Last Update Date | 2019-10-14 |