NPI | 1720405939 |
---|---|
Former Name | HEIDI BRESCIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ MP00599500) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 3159) |
Enumeration Date | 2014-03-25 |
Last Update Date | 2024-05-15 |