| NPI | 1881255230 |
|---|---|
| Former Name | ASHLEY MARIE JANICKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2023-06-01 |