| NPI | 1275192353 |
|---|---|
| Former Name | ABBIGAIL BOOMHOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2023-09-13 |