| NPI | 1336610856 |
|---|---|
| Former Name | OLIVIA LAUREL WEISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111738) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9111738) |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2026-01-03 |