| NPI | 1073506275 |
|---|---|
| Former Name | CORINNE L ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008155) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 1917) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2017-04-28 |