NPI | 1871610022 |
---|---|
Former Name | MEGAN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2167) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2167) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2020-12-02 |