NPI | 1033534847 |
---|---|
Former Name | WHITNEY KONZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4925) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA23286) |
Enumeration Date | 2014-03-03 |
Last Update Date | 2022-04-20 |