NPI | 1245679810 |
---|---|
Former Name | JOEY RACHEL HERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007762) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004664) |
Enumeration Date | 2013-06-17 |
Last Update Date | 2019-02-18 |