| 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 |