NPI | 1134421100 |
---|---|
Former Name | REBECCA CZERNIAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2697) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2697) |
Enumeration Date | 2010-11-24 |
Last Update Date | 2023-10-06 |