NPI | 1831727486 |
---|---|
Former Name | AUTUMN LUGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2549) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-30 |
Last Update Date | 2024-06-10 |