NPI | 1023166477 |
---|---|
Former Name | EVA BERNACIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.322) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9112050) |
363AM0700X Physician Assistant, Medical (Licence: MO 2011005793) | |
Enumeration Date | 2007-01-08 |
Last Update Date | 2021-07-19 |