| NPI | 1932681764 |
|---|---|
| Former Name | VANESSA CHRISITNA CASTOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 61100713) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2021-01-12 |