| NPI | 1598249765 |
|---|---|
| Former Name | VICTORIA DANIELLE KISSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006282RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: 2192) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2020-01-03 |