NPI | 1982957700 |
---|---|
Former Name | WHITNEY MARIE RONAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006465) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006465) |
Enumeration Date | 2012-10-17 |
Last Update Date | 2015-12-28 |