NPI | 1346741295 |
---|---|
Former Name | JACLYN STEINKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007220) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4038) |
Enumeration Date | 2018-02-26 |
Last Update Date | 2024-10-15 |