| NPI | 1205203759 |
|---|---|
| Former Name | MARIA VLADIMIR BORTKEVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 007845) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2021-01-11 |