NPI | 1366636987 |
---|---|
Former Name | VICTORIA A LUKASZEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50002601) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-447) |
Enumeration Date | 2007-08-28 |
Last Update Date | 2012-07-10 |