| NPI | 1326074998 |
|---|---|
| Former Name | VIKTORIYA AVADVAYEVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 2124) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 000718) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2015-10-07 |