NPI | 1043663024 |
---|---|
Former Name | GINA K PORTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.009427RX) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3700) |
Enumeration Date | 2016-07-14 |
Last Update Date | 2025-10-02 |