| NPI | 1225090517 |
|---|---|
| Former Name | TINA MICHELLE FROST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103179) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |