NPI | 1255426870 |
---|---|
Former Name | KELLI ANN DIPATRIZIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3060) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3060) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2019-01-16 |