NPI | 1265963177 |
---|---|
Former Name | DIANE JELINSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Enumeration Date | 2017-03-22 |
Last Update Date | 2023-05-10 |