NPI | 1336755065 |
---|---|
Former Name | KATHERINE C ZAZULAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025641) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 25641) |
Enumeration Date | 2020-09-18 |
Last Update Date | 2024-01-30 |