NPI | 1932524881 |
---|---|
Former Name | MARTA M KOWALIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111264) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006250) |
363AM0700X Physician Assistant, Medical (Licence: PA MA056748) | |
Enumeration Date | 2014-03-03 |
Last Update Date | 2018-07-09 |