NPI | 1962446930 |
---|---|
Former Name | CORY LOUISE CAMERON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004797) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004797) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2021-08-09 |