NPI | 1619926649 |
---|---|
Former Name | JOANNA J BOWMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004738) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004738) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2011-11-02 |