NPI | 1013000488 |
---|---|
Former Name | JACQUELINE MARSHIANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107624) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL1873) |
Enumeration Date | 2006-09-30 |
Last Update Date | 2015-06-24 |