NPI | 1710531264 |
---|---|
Former Name | AMBER WOBMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010202) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-08-01 |
Last Update Date | 2023-10-23 |