NPI | 1770216079 |
---|---|
Former Name | BROOKE ANN POLZER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 841523) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-07-05 |
Last Update Date | 2025-08-29 |