| NPI | 1568830487 |
|---|---|
| Former Name | ALISA MARIE RACIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC172) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2024-07-09 |