| NPI | 1720485550 |
|---|---|
| Former Name | ALYSSA SURBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001773A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001773A) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2025-01-02 |