NPI | 1285256677 |
---|---|
Former Name | PAIGE KOERPERICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5078) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-05-08 |
Last Update Date | 2022-08-12 |