NPI | 1417106519 |
---|---|
Former Name | MICHELENE J METZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003681) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2339-023) |
Enumeration Date | 2008-09-12 |
Last Update Date | 2019-08-28 |