NPI | 1417787813 |
---|---|
Former Name | ALECIA BEIMBORN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6261) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00848) |
Enumeration Date | 2024-08-01 |
Last Update Date | 2024-11-15 |