NPI | 1700432994 |
---|---|
Former Name | LOREN ELIZABETH DANESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3287) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001329) |
Enumeration Date | 2019-08-13 |
Last Update Date | 2024-10-24 |