NPI | 1932629649 |
---|---|
Former Name | ALYSSA FAITH DILLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11185) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00435800) |
Enumeration Date | 2017-06-23 |
Last Update Date | 2024-11-14 |