| NPI | 1972771020 |
|---|---|
| Former Name | EMILY ELIZABETH MALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 001836) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001836) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085003198) | |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2023-11-21 |