| NPI | 1528650918 |
|---|---|
| Former Name | MADELINE SURACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.010094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007538RX) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2024-01-19 |