NPI | 1699225557 |
---|---|
Former Name | HALEY INNOCENTI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002146A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99075595A) |
Enumeration Date | 2016-10-04 |
Last Update Date | 2023-01-05 |