| NPI | 1699062851 |
|---|---|
| Former Name | MICHELLE K KOENIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3241) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2021-04-27 |