NPI | 1851743561 |
---|---|
Former Name | MIA MALIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61129329) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3392) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2023-06-22 |