NPI | 1770941841 |
---|---|
Former Name | CARRIE MARIE UMBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 324102) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2459) |
Enumeration Date | 2016-02-04 |
Last Update Date | 2020-12-17 |