NPI | 1538263645 |
---|---|
Former Name | PENNY LYNN FLEEGEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1724) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-09-11 |
Last Update Date | 2020-12-12 |