NPI | 1528441854 |
---|---|
Former Name | AMANDA M AJINE-BASIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009765) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057154) |
Enumeration Date | 2015-07-06 |
Last Update Date | 2021-01-19 |