| NPI | 1124410444 |
|---|---|
| Former Name | WILLIAM MCMILLAN-GRELLO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1123217) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2022-05-20 |