NPI | 1689611402 |
---|---|
Former Name | DEANNA DAKROUB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004096) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103122) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2012-10-10 |