NPI | 1326633629 |
---|---|
Former Name | JORDYN J BURDICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010558) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-03-08 |
Last Update Date | 2022-11-28 |