| NPI | 1134595978 |
|---|---|
| Former Name | TRACY E WEIGEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12367) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3974) |
| 363A00000X Physician Assistant (Licence: ND PAC0616) | |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2017-11-29 |