NPI | 1679118269 |
---|---|
Former Name | ALEXANDRA MARIE HARTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA061223) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: PA OA005105) | |
Enumeration Date | 2019-11-07 |
Last Update Date | 2023-11-09 |