NPI | 1659866044 |
---|---|
Former Name | ELIZABETH EMMERICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4394) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 4394) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2021-08-04 |