NPI | 1679283469 |
---|---|
Former Name | ALAINA GROTTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64827) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61397064) |
363AS0400X Physician Assistant, Surgical (Licence: CA PA64827) | |
Enumeration Date | 2022-12-01 |
Last Update Date | 2024-11-15 |