NPI | 1871230417 |
---|---|
Other Name | ABIGAIL KELLY MANGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008656) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-05-16 |
Last Update Date | 2025-01-23 |