NPI | 1093226557 |
---|---|
Former Name | ASHLEY GOMOLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060142) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-10-23 |
Last Update Date | 2024-08-27 |