NPI | 1992170336 |
---|---|
Former Name | ALYSE ORYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA8390) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007634) |
Enumeration Date | 2015-12-10 |
Last Update Date | 2022-02-11 |