| NPI | 1487214235 |
|---|---|
| Former Name | PAIGE C FEDRO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006708) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006708) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-01-25 |