NPI | 1477224582 |
---|---|
Former Name | VIOLETTE E TANGUAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063032) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2021-09-28 |
Last Update Date | 2021-09-28 |