| NPI | 1033622501 |
|---|---|
| Former Name | MADELINE MARIE FRIESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2934) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059563) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2019-04-30 |