NPI | 1922669191 |
---|---|
Former Name | MEAGAN BEERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008365) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006026RX) |
Enumeration Date | 2019-06-27 |
Last Update Date | 2021-12-08 |