| NPI | 1164072286 |
|---|---|
| Professional Name | THERESA VAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA202904) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2024-10-01 |