NPI | 1033653142 |
---|---|
Former Name | LARISSA A QUADRACCI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60715586) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60715586) |
Enumeration Date | 2016-12-07 |
Last Update Date | 2024-05-13 |