NPI | 1104119874 |
---|---|
Former Name | SHEILA OBRADOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105799) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2079) |
Enumeration Date | 2011-05-27 |
Last Update Date | 2023-08-16 |