| NPI | 1174032171 |
|---|---|
| Former Name | VERNICA JADE MIKSCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME 1141018) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028038) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 28038) | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2023-07-17 |