NPI | 1316202302 |
---|---|
Former Name | BRADLEIGH ROSE ZITO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 352823) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22907) |
363A00000X Physician Assistant (Licence: AL PA.1150) | |
363A00000X Physician Assistant (Licence: NC 0010-03629) | |
Enumeration Date | 2012-07-06 |
Last Update Date | 2025-10-03 |