NPI | 1255895017 |
---|---|
Former Name | VICTORIA CULLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MS PA00419) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MS PA00419) |
363AS0400X Physician Assistant, Surgical (Licence: TN 3785) | |
363AM0700X Physician Assistant, Medical (Licence: TN 3785) | |
Enumeration Date | 2019-01-25 |
Last Update Date | 2024-04-17 |