NPI | 1255970489 |
---|---|
Former Name | ANMOL G MANCHALA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12107) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13330) |
363AM0700X Physician Assistant, Medical (Licence: MN 13330) | |
Enumeration Date | 2020-01-06 |
Last Update Date | 2022-03-15 |