NPI | 1750436408 |
---|---|
Former Name | ABBY LEE EILBECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001766) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003968) |
363AM0700X Physician Assistant, Medical (Licence: IA 1766) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2022-10-27 |