| NPI | 1306155007 |
|---|---|
| Former Name | DANIELLE ANTONETTE HABERERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21161) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21161) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2020-10-24 |