NPI | 1548619646 |
---|---|
Former Name | JILLIAN MIRCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007852) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2016-06-09 |
Last Update Date | 2023-03-06 |