NPI | 1619607165 |
---|---|
Former Name | MAKAYLEA VICARI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008732) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-15 |
Last Update Date | 2023-11-17 |