NPI | 1932548658 |
---|---|
Former Name | HEATHER J MCDANIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA1404) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 59576) |
Enumeration Date | 2013-06-15 |
Last Update Date | 2023-10-13 |