| 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 |