NPI | 1083084628 |
---|---|
Former Name | CHELSEA ANN BLOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007560) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601007560) |
Enumeration Date | 2015-09-25 |
Last Update Date | 2019-02-06 |