NPI | 1457003600 |
---|---|
Former Name | ABIGAIL BERLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02578) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-01-19 |
Last Update Date | 2023-02-24 |