| NPI | 1447348545 |
|---|---|
| Former Name | COURTNEY BOEHME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2069) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA750) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2022-08-22 |