| NPI | 1225311368 |
|---|---|
| Former Name | ERIN KATHLEEN MUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99048750A) |
| 363A00000X Physician Assistant (Licence: NY 23 015843) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2015-06-26 |