NPI | 1174195572 |
---|---|
Former Name | HANNAH GOULIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2021-07-14 |
Last Update Date | 2023-02-07 |