NPI | 1417046459 |
---|---|
Former Name | COURTNEY MARIE KOEHNEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 178921) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-10-11 |
Last Update Date | 2025-06-12 |