NPI | 1699118364 |
---|---|
Former Name | KORI IMONDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 4620) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1975) |
363AM0700X Physician Assistant, Medical (Licence: MA 4620) | |
363AS0400X Physician Assistant, Surgical (Licence: MA 4620) | |
Enumeration Date | 2013-04-12 |
Last Update Date | 2023-02-21 |