NPI | 1134651433 |
---|---|
Former Name | ALEXANDRA T GAST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 73947) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 282532) |
Enumeration Date | 2017-03-28 |
Last Update Date | 2023-05-04 |