NPI | 1124363650 |
---|---|
Former Name | KATHERINE TRUSCELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109684) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03835) |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9109684) | |
Enumeration Date | 2012-12-10 |
Last Update Date | 2020-11-24 |