NPI | 1063410934 |
---|---|
Former Name | JOANNA NIEMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50001281) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50001281) |
Enumeration Date | 2005-07-13 |
Last Update Date | 2021-01-07 |