NPI | 1326568668 |
---|---|
Former Name | ADELE MICHIKO ROCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13038) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-06-27 |
Last Update Date | 2019-10-03 |