| NPI | 1073109864 |
|---|---|
| Former Name | ALISSA ROSALIA BOLEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX PA13956) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: TX PA13956) | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2024-11-19 |