| NPI | 1851748024 |
|---|---|
| Former Name | ANNIE MAE O'CONNOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008118) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001069) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2021-10-01 |