NPI | 1417180175 |
---|---|
Former Name | JESSICA BAUMCHEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01336) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS T-02588) |
Enumeration Date | 2009-08-28 |
Last Update Date | 2024-01-22 |