NPI | 1508890096 |
---|---|
Former Name | AMY B BLASZKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052542) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052542) |
363AS0400X Physician Assistant, Surgical (Licence: PA MA052542) | |
Enumeration Date | 2006-07-10 |
Last Update Date | 2021-02-04 |