| NPI | 1245418722 |
|---|---|
| Former Name | THERESE PIACENTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03434) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 180313) |
| 363AS0400X Physician Assistant Surgical (Licence: MA 1980) | |
| 363AS0400X Physician Assistant Surgical (Licence: VT 055.0031325) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2021-05-26 |