| NPI | 1982989885 |
|---|---|
| Former Name | MEGAN JO CLEMENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5014) |
| 363A00000X Physician Assistant (Licence: CO PA.0003925) | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2018-12-18 |