NPI | 1942221585 |
---|---|
Former Name | MEGGAN MICHELLE GOODWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021041128) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04904) |
363A00000X Physician Assistant (Licence: IL 085009473) | |
Enumeration Date | 2006-07-21 |
Last Update Date | 2023-02-08 |