NPI | 1841397031 |
---|---|
Former Name | JODI RENDE ZYCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4336) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003154) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2022-10-13 |