NPI | 1821264599 |
---|---|
Former Name | LEANN VILMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00593) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00593) |
Enumeration Date | 2008-05-02 |
Last Update Date | 2022-11-15 |