| NPI | 1295017523 |
|---|---|
| Former Name | GISELE RENEE FASSINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA192781) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 21635) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2020-10-28 |