NPI | 1326357070 |
---|---|
Former Name | AMBER ANN JANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-948) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA152970) |
Enumeration Date | 2010-09-29 |
Last Update Date | 2018-02-15 |