NPI | 1295073815 |
---|---|
Former Name | NICOLE BUDJENSKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58322) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107158) |
363A00000X Physician Assistant (Licence: WA PA60671158) | |
Enumeration Date | 2013-01-17 |
Last Update Date | 2022-02-16 |