NPI | 1639325376 |
---|---|
Former Name | CHARLENE K SKUBOVIUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107673) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002517) |
Enumeration Date | 2008-08-13 |
Last Update Date | 2022-12-23 |