NPI | 1710924600 |
---|---|
Former Name | JANE KRISTINE FOLGERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA609) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA609) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2025-03-20 |