NPI | 1922575034 |
---|---|
Former Name | ALYSSA MICHELLE O'BRIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11228) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD c0006992) |
363A00000X Physician Assistant (Licence: VA 0110-006681) | |
Enumeration Date | 2018-10-26 |
Last Update Date | 2022-11-30 |