NPI | 1407403751 |
---|---|
Former Name | MARIA BARAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 004633) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 004633) |
363AS0400X Physician Assistant, Surgical (Licence: CT 004633) | |
Enumeration Date | 2019-08-21 |
Last Update Date | 2022-12-29 |