NPI | 1528343555 |
---|---|
Former Name | CONSTANCE ESTIPONA DARUTHAYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58551) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60198953) |
Enumeration Date | 2011-10-21 |
Last Update Date | 2023-12-08 |