NPI | 1255877031 |
---|---|
Former Name | JAMI TERESA WEISS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12350) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007748) |
Enumeration Date | 2017-01-17 |
Last Update Date | 2024-06-13 |