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Individual
MONICA M BOMAR
Active
Individual
MONICA M BOMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-484
AR
363AM0700X
Medical Physician Assistant
P-T1224
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193007795
—
AR
Enumeration date
07/30/2012
Last updated
01/30/2019
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