| NPI | 1467492637 |
|---|---|
| Former Name | MICHELLE TULL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3006) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-02-23 |