NPI | 1922193192 |
---|---|
Former Name | KAAREN L MAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2004-0011) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM PA2004-0011) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2024-11-18 |