| NPI | 1912579194 | 
|---|---|
| Former Name | MADELINE A HIMPELMANN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14444) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008368) | 
| Enumeration Date | 2021-07-15 | 
| Last Update Date | 2023-10-16 |