NPI | 1619038288 |
---|---|
Former Name | ASHLEY MCCLAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006385) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001923) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2023-11-17 |