| NPI | 1649942533 |
|---|---|
| Former Name | ALYSSA ANN SCALLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026858-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 324298) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-09-29 |