NPI | 1902315708 |
---|---|
Former Name | ANASTASIA ARENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8887) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 4229) |
363A00000X Physician Assistant | |
Enumeration Date | 2017-09-25 |
Last Update Date | 2022-08-15 |