NPI | 1295546851 |
---|---|
Former Name | KATE MARIE PUCA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012979) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2025-01-14 |
Last Update Date | 2025-05-14 |