NPI | 1225283088 |
---|---|
Former Name | MICHELLE SIMANCAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05697) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030556) |
Enumeration Date | 2008-11-20 |
Last Update Date | 2016-05-03 |