NPI | 1821472390 |
---|---|
Former Name | ASHTYN JUNE BOHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0876) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2015-07-15 |
Last Update Date | 2021-11-16 |