NPI | 1134102502 |
---|---|
Former Name | ALLA KAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10194) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-001385) |
Enumeration Date | 2005-11-21 |
Last Update Date | 2012-10-19 |