NPI | 1144787680 |
---|---|
Former Name | ALLISON RAE KOSOBUD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13528) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1144787680) |
Enumeration Date | 2019-02-20 |
Last Update Date | 2024-12-31 |