NPI | 1558315606 |
---|---|
Former Name | SUZANNE MARY OKOLITA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3558) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002599) |
363AS0400X Physician Assistant, Surgical (Licence: AZ 3558) | |
Enumeration Date | 2006-05-22 |
Last Update Date | 2023-08-24 |