NPI | 1417232752 |
---|---|
Former Name | ALEXA LIANE KUNDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2867) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11520) |
Enumeration Date | 2011-10-19 |
Last Update Date | 2021-11-01 |