| NPI | 1366438111 |
|---|---|
| Former Name | ALICIA MARIE KOENIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10288) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102154) |
| 363A00000X Physician Assistant (Licence: FL PA9102154) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-10288) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2021-05-21 |