| NPI | 1336635077 | 
|---|---|
| Former Name | ALLISON HALLBACH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical | 
| Enumeration Date | 2018-07-05 | 
| Last Update Date | 2025-04-03 |