NPI | 1659739704 |
---|---|
Former Name | OLENA L DELUCA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6332) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-02-04 |
Last Update Date | 2021-03-12 |