| NPI | 1346911237 |
|---|---|
| Former Name | RANDI MIELKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61186369) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2023-02-21 |