NPI | 1396076634 |
---|---|
Former Name | CHRISTINE WENTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004109) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115395) |
Enumeration Date | 2010-01-27 |
Last Update Date | 2024-08-27 |