NPI | 1851601702 |
---|---|
Former Name | ELLEN M FRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5713) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 50363) |
Enumeration Date | 2010-10-13 |
Last Update Date | 2023-05-11 |