| NPI | 1700414711 |
|---|---|
| Former Name | CARISSA ROHDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5518) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2021-10-29 |