NPI | 1376019786 |
---|---|
Former Name | MARISSA CATHERINE NIEMEYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007561) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-10-23 |
Last Update Date | 2022-11-18 |