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 |