NPI | 1902358955 |
---|---|
Former Name | MONICA HOLLOWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT MED-PAC-LIC-585669) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA179151) |
Enumeration Date | 2016-10-25 |
Last Update Date | 2023-01-10 |