NPI | 1073515714 |
---|---|
Former Name | MARCY A SCHULTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022040627) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002359) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2023-10-06 |