NPI | 1811905383 |
---|---|
Former Name | MINDY LOUISE HOUCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11065) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052560) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2020-08-24 |