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 |