NPI | 1750839692 |
---|---|
Former Name | DANIELLE HOLIC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4278) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020131) |
Enumeration Date | 2016-09-21 |
Last Update Date | 2022-11-30 |