NPI | 1902233471 |
---|---|
Former Name | TRISHA RAE MANION |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006745) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2013-09-30 |
Last Update Date | 2017-06-20 |