| NPI | 1801989165 |
|---|---|
| Former Name | ANDREA ARLENE WICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0003208) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030404) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2023-04-06 |