NPI | 1477859577 |
---|---|
Former Name | MICHELLE CHANG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059532) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 23007) |
Enumeration Date | 2011-02-07 |
Last Update Date | 2018-03-17 |