NPI | 1649239278 |
---|---|
Former Name | PAMELA J CROSSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA203665) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 3302) |
Enumeration Date | 2006-03-22 |
Last Update Date | 2022-01-26 |