| NPI | 1225155427 |
|---|---|
| Former Name | ANNA PENCHACEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9114245) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA051562) |
| 363A00000X Physician Assistant (Licence: PA MA051562) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2021-07-15 |