NPI | 1467636787 |
---|---|
Former Name | RENAE MUELLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0002974) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005322) |
Enumeration Date | 2007-12-21 |
Last Update Date | 2018-06-27 |