NPI | 1548719073 |
---|---|
Former Name | ELLEN BOBICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11834) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD005118) |
Enumeration Date | 2016-09-26 |
Last Update Date | 2024-10-09 |