NPI | 1033742580 |
---|---|
Former Name | COLLEEN MARSALA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5156-023) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2020-02-12 |
Last Update Date | 2024-02-01 |