NPI | 1407557515 |
---|---|
Former Name | CASSANDRA BOHNSACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15075) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-03-15 |
Last Update Date | 2024-12-12 |