NPI | 1427591510 |
---|---|
Former Name | ARIANNA MARIE TATARCZUK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3711) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 23.003711) |
Enumeration Date | 2016-11-22 |
Last Update Date | 2019-05-28 |