| 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 |