NPI | 1003551920 |
---|---|
Former Name | ANNEMARIE ROSE AMLUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007567RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4960) |
Enumeration Date | 2022-05-04 |
Last Update Date | 2022-06-21 |