NPI | 1740806132 |
---|---|
Other Name | VANESSA RENEE IANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003438A) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10003438A) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-06-22 |
Last Update Date | 2022-12-27 |