| NPI | 1134775851 |
|---|---|
| Former Name | ALEXANDRA OTTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011250) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9289) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2025-09-29 |