NPI | 1114222429 |
---|---|
Former Name | CHRISTINA MARIE LANGEVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002531) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002531) |
363AS0400X Physician Assistant, Surgical (Licence: CT 002531) | |
Enumeration Date | 2011-01-18 |
Last Update Date | 2015-04-02 |