| NPI | 1013430073 |
|---|---|
| Former Name | WHITNEY JO BOEDEKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4134) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4134-23) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2024-10-03 |