NPI | 1902136906 |
---|---|
Former Name | MACKENZIE ADELLE KNOBBE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA006579) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2010-01-14 |
Last Update Date | 2014-05-29 |