| NPI | 1063815017 |
|---|---|
| Former Name | CARISSA L ROBERGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005227) |
| 363A00000X Physician Assistant (Licence: 081387) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2024-07-13 |