NPI | 1831493212 |
---|---|
Former Name | KARLA M BALES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005806) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9105389) |
Enumeration Date | 2010-12-29 |
Last Update Date | 2022-07-21 |