NPI | 1548658644 |
---|---|
Former Name | ASHLEY POLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007289) |
Enumeration Date | 2014-12-26 |
Last Update Date | 2017-01-17 |