NPI | 1558147090 |
---|---|
Former Name | CHELSEA BOSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004312A) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-08-31 |
Last Update Date | 2024-11-01 |