| NPI | 1891222543 |
|---|---|
| Former Name | MEGAN AMANDA ZELLMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12608) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 086896) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-04-06 |