NPI | 1518047133 |
---|---|
Former Name | CARAMARIE C BROCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004514) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004514) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2024-06-18 |