| NPI | 1558897413 |
|---|---|
| Former Name | MASHA KATHERINE PREOBRAZHENSKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 10618366-1206) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-11-08 |