NPI | 1053770222 |
---|---|
Former Name | MARIA ELISE PORTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007699) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2016-02-17 |
Last Update Date | 2024-08-22 |