NPI | 1952659104 |
---|---|
Former Name | MICHALENA GROSSHANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018419) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363A00000X Physician Assistant (Licence: NY 18419) | |
Enumeration Date | 2012-08-20 |
Last Update Date | 2023-06-29 |