NPI | 1457503740 |
---|---|
Former Name | CRISTINA MIRANDA CHALK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8747) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1347) |
Enumeration Date | 2008-10-17 |
Last Update Date | 2025-03-27 |