| NPI | 1750767927 |
|---|---|
| Former Name | MINDY MICHELLE GAUBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00558) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2023-01-04 |