NPI | 1053657668 |
---|---|
Former Name | CHELSEY A SPADT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00299600) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055855) |
Enumeration Date | 2012-12-31 |
Last Update Date | 2015-03-05 |