| NPI | 1275369332 |
|---|---|
| Former Name | ALYSSA R PHELPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004529A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10004529A) |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-30 |