| NPI | 1598472912 |
|---|---|
| Former Name | ELIZABETH ANNE JANKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2023002004) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2023-02-17 |