NPI | 1740913177 |
---|---|
Former Name | ABIGAYLE WELLNITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7447-23) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-07-04 |
Last Update Date | 2023-11-07 |