| NPI | 1063061604 |
|---|---|
| Former Name | MIROSLAV JURISIC |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00536100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4440) |
| 363A00000X Physician Assistant (Licence: NY 023789) | |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2023-06-08 |