NPI | 1699951152 |
---|---|
Former Name | MICHELLE LOUISE VOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005402) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60102427) |
363AS0400X Physician Assistant, Surgical (Licence: AZ 4271) | |
Enumeration Date | 2008-01-15 |
Last Update Date | 2021-08-02 |