NPI | 1174993463 |
---|---|
Former Name | DARIA ELIZABETH KANEVSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA227954) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1300) |
363A00000X Physician Assistant (Licence: WA PA.61532103) | |
Enumeration Date | 2015-09-30 |
Last Update Date | 2025-10-03 |