NPI | 1134510803 |
---|---|
Former Name | ANGIE MARIE BAUMERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1895) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1895) |
Enumeration Date | 2015-02-16 |
Last Update Date | 2018-10-18 |