| NPI | 1285053728 |
|---|---|
| Former Name | NATALIE WALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3379) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-10-02 |