NPI | 1619419991 |
---|---|
Former Name | CATHERINE DAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2295) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006063) |
Enumeration Date | 2016-11-17 |
Last Update Date | 2022-04-26 |