NPI | 1487684163 |
---|---|
Former Name | LARA MICHELE HOSHKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PENDING) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006162) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2022-11-29 |