NPI | 1114131000 |
---|---|
Former Name | ANNA OZERYANSKAYA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60268441) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-001942) |
363AM0700X Physician Assistant, Medical (Licence: WA PA60268441) | |
363AS0400X Physician Assistant, Surgical (Licence: WA PA60268441) | |
Enumeration Date | 2007-05-09 |
Last Update Date | 2015-08-31 |