NPI | 1609069566 |
---|---|
Former Name | JACQUELINE J WINNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005156) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2007-08-23 |
Last Update Date | 2020-09-16 |