NPI | 1760681688 |
---|---|
Former Name | ALYSSA JEANNE MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA0004380) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01245) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2023-03-07 |