| NPI | 1154763050 |
|---|---|
| Former Name | MICHELLE RENAE-PIPPEL JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OR PA173678) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2021-01-14 |