NPI | 1518497338 |
---|---|
Former Name | LAURETTA ACHA AMBE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059047) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001242) |
363A00000X Physician Assistant (Licence: MO PA200001242) | |
Enumeration Date | 2017-06-14 |
Last Update Date | 2024-04-04 |