| NPI | 1437748803 |
|---|---|
| Former Name | MICHELLE ANN FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5278) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: UT 121040071206) |
| 363AS0400X Physician Assistant Surgical (Licence: UT 121040071206) | |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2023-01-18 |