NPI | 1508312661 |
---|---|
Former Name | CELENA POLLOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9896) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-763) |
Enumeration Date | 2016-08-29 |
Last Update Date | 2024-01-18 |