NPI | 1538672068 |
---|---|
Former Name | MICHELLE JACLYN GARCIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55439) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-11-06 |
Last Update Date | 2020-12-21 |