NPI | 1841698677 |
---|---|
Former Name | STASIA ANNA LANGENFELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004879) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NE 1871) |
Enumeration Date | 2014-12-10 |
Last Update Date | 2019-03-21 |