| NPI | 1376559401 | 
|---|---|
| Former Name | AMBER L HAAG | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002729A)  | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31004330A)  | 
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2019-07-16 |