NPI | 1992705131 |
---|---|
Former Name | DEANINE M. DECKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006889) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2022-03-21 |