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 |