| NPI | 1710436720 |
|---|---|
| Former Name | JELENA HASANOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7959) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 3725) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2021-06-09 |