NPI | 1548773690 |
---|---|
Former Name | CAROLINE N BAUKNECHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11385) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3451) |
Enumeration Date | 2017-11-12 |
Last Update Date | 2023-01-12 |