NPI | 1073865804 |
---|---|
Former Name | SERENA HAFFNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106751) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9106751) |
Enumeration Date | 2012-10-03 |
Last Update Date | 2024-07-17 |