NPI | 1356462030 |
---|---|
Professional Name | VENITA R. FLUCKER PA-C |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-001970) |
Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 85001970) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2021-04-23 |