NPI | 1821548140 |
---|---|
Former Name | AVERY DANIELLE CERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058611) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003982) |
Enumeration Date | 2016-10-11 |
Last Update Date | 2022-10-18 |