NPI | 1508497884 |
---|---|
Former Name | DARYA KORSHUKOVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9119743) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009218) |
Enumeration Date | 2020-01-27 |
Last Update Date | 2025-03-19 |