NPI | 1255965232 |
---|---|
Former Name | MING JUN LIETSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 110490) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 110490) |
Enumeration Date | 2020-02-27 |
Last Update Date | 2023-03-08 |