NPI | 1366607681 |
---|---|
Former Name | ASTRA GANGAPERSAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110245) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2008-07-25 |
Last Update Date | 2018-12-19 |