| NPI | 1598264442 |
|---|---|
| Former Name | MICHELLE MARIE LOHBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5729-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 090813) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2022-02-09 |