NPI | 1235749276 |
---|---|
Former Name | DANNA SELF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA1670) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-08-04 |
Last Update Date | 2023-03-22 |