NPI | 1750647244 |
---|---|
Former Name | ANNIKA KAMBERELIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004033) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2701) |
Enumeration Date | 2012-04-09 |
Last Update Date | 2024-01-08 |