NPI | 1205238367 |
---|---|
Other Name | JESSICA BASTIDAS-CELLERI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085005220) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005220) |
Enumeration Date | 2014-09-20 |
Last Update Date | 2024-04-09 |