NPI | 1164770087 |
---|---|
Former Name | MARIE BERSAMIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003991) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001181285) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2012-09-07 |