NPI | 1194219717 |
---|---|
Former Name | REGAN KAESTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059806) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004480) |
Enumeration Date | 2018-06-18 |
Last Update Date | 2022-01-20 |