| NPI | 1952627986 |
|---|---|
| Former Name | MARINA JOY WAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1049) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110003294) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-11-15 |