| NPI | 1619336088 |
|---|---|
| Former Name | ADRIENNE ELIZABETH DIFONSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058086) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058086) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA058086) | |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2022-10-25 |