NPI | 1154747129 |
---|---|
Former Name | JENNA MARALDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002027A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09027) |
Enumeration Date | 2014-03-13 |
Last Update Date | 2023-03-07 |