| NPI | 1578102455 |
|---|---|
| Former Name | MADISON ALTWIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7347) |
| Enumeration Date | 2019-12-25 |
| Last Update Date | 2023-11-30 |