| NPI | 1003202623 |
|---|---|
| Former Name | ALEXANDRA RUSETZKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601007303) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007303) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2021-03-05 |