NPI | 1790908887 |
---|---|
Former Name | LYNSEY M MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004918) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004918) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2020-10-14 |