| NPI | 1003103003 |
|---|---|
| Former Name | CARRIE ELIZABETH PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063198) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2024-05-28 |