NPI | 1487774097 |
---|---|
Former Name | TERRI LYNN PEISCHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003699) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004696) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2016-03-28 |