NPI | 1942535109 |
---|---|
Former Name | MOLLY ELIZABETH HERRMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 1090341) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003614) |
Enumeration Date | 2009-10-06 |
Last Update Date | 2021-01-12 |