NPI | 1811449028 |
---|---|
Former Name | MARKE SCHULDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14496) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002200A) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36001998A) | |
Enumeration Date | 2016-11-04 |
Last Update Date | 2023-05-31 |