NPI | 1417121781 |
---|---|
Former Name | DONNA J MACKENZIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2576) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 2576) |
Enumeration Date | 2008-04-17 |
Last Update Date | 2021-05-28 |