| NPI | 1831790591 |
|---|---|
| Former Name | BAILEY N. MANTHA-NAGRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61101539) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61101539) |
| Enumeration Date | 2020-11-07 |
| Last Update Date | 2022-08-18 |