NPI | 1013000728 |
---|---|
Former Name | TAMARA ANN VIRGILIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C03461) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1619) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2011-04-11 |