NPI | 1720547417 |
---|---|
Former Name | SINEAD DEIRDRE CHISA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006585) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2244) |
Enumeration Date | 2019-03-13 |
Last Update Date | 2021-03-12 |