| NPI | 1730489261 |
|---|---|
| Former Name | ANN MARIE GUMMOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003895) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2019-04-02 |