NPI | 1891955423 |
---|---|
Former Name | LEAH MARIE POLLASTRINI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 089704) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110002709) |
363A00000X Physician Assistant (Licence: VA 0110002709) | |
Enumeration Date | 2008-06-17 |
Last Update Date | 2018-04-25 |