| NPI | 1073891149 |
|---|---|
| Former Name | CHARNAI DAWN FANKHANEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2808) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 2808-023) |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2021-11-22 |