NPI | 1235837733 |
---|---|
Former Name | MCKENZIE ANN LOOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12995) |
Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NC 0010-12995) |
Enumeration Date | 2023-02-23 |
Last Update Date | 2023-03-06 |