NPI | 1356749808 |
---|---|
Former Name | CRYSTAL LYNN ZELINSKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010834) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005601) |
Enumeration Date | 2014-12-16 |
Last Update Date | 2021-11-17 |