NPI | 1710904255 |
---|---|
Former Name | ELAINE MARIE SOMMERHAUSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 1500532) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1338469061) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2011-08-10 |