| NPI | 1447699491 |
|---|---|
| Former Name | OLYMPIA THALASSITES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9108742) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IN 10001521A) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-10-19 |