NPI | 1902398753 |
---|---|
Former Name | BRIANNA DZIEDZIC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00486600) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00486600) |
Enumeration Date | 2018-06-06 |
Last Update Date | 2024-12-09 |