NPI | 1558969568 |
---|---|
Former Name | RACHELLE SCHMUDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5103-023) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-10-12 |
Last Update Date | 2021-11-29 |