NPI | 1144672361 |
---|---|
Former Name | ALEXANDRA MARIE DEVRIES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60651791) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ID PA1916) |
Enumeration Date | 2016-07-12 |
Last Update Date | 2024-11-15 |