NPI | 1649615444 |
---|---|
Former Name | AUDRA E EGGERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61260795) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA182433) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA61260795) | |
363AS0400X Physician Assistant, Surgical (Licence: OR PA182433) | |
Enumeration Date | 2013-05-07 |
Last Update Date | 2022-08-02 |