| NPI | 1558848317 |
|---|---|
| Former Name | ALLIE VANDENBERGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1153) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2024-11-22 |