NPI | 1336199165 |
---|---|
Former Name | SUZANNE LOWERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004752) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004752) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2011-02-16 |