| NPI | 1972577633 |
|---|---|
| Former Name | MICHELLE ANN DOMASKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103509) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 103509) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2019-11-22 |