| NPI | 1255878666 |
|---|---|
| Former Name | CANDICE PELLERIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52855) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108988) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |