NPI | 1396223095 |
---|---|
Former Name | JAIME ELIZABETH NITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 4494-23) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 4494-23) |
Enumeration Date | 2018-08-03 |
Last Update Date | 2023-05-04 |