NPI | 1699242883 |
---|---|
Former Name | SVIJETLANA OBERKIRSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: 001008988) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08988) |
Enumeration Date | 2018-10-26 |
Last Update Date | 2023-11-03 |