NPI | 1265171250 |
---|---|
Former Name | GRACE MARY POLGAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011118) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-05-31 |
Last Update Date | 2023-02-08 |