NPI | 1023444601 |
---|---|
Former Name | RACHELLE CARIELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7525) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107332) |
363AM0700X Physician Assistant, Medical (Licence: GA 7525) | |
Enumeration Date | 2013-09-16 |
Last Update Date | 2024-10-01 |