NPI | 1881119378 |
---|---|
Former Name | TAYLOR JAN BERUBE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6177) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA PA6177) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2022-08-17 |