NPI | 1083042444 |
---|---|
Former Name | MICHELLE NICOLE STILES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-04449) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001004449) |
Enumeration Date | 2013-10-23 |
Last Update Date | 2021-02-19 |