| NPI | 1992479265 |
|---|---|
| Former Name | MARY E PETRO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005740) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-03-14 |