NPI | 1730581257 |
---|---|
Former Name | VANESSA A CLOSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118949) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2175) |
Enumeration Date | 2014-09-16 |
Last Update Date | 2024-08-15 |