NPI | 1508869157 |
---|---|
Former Name | PAULA DEANNE DIETSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA000475) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10003216) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2024-03-21 |