NPI | 1235653833 |
---|---|
Former Name | ALYSSA JANOSKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110446) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-07-26 |
Last Update Date | 2019-09-18 |