NPI | 1942478656 |
---|---|
Former Name | ROSE CALI ST. JACQUES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9102203) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102203) |
Enumeration Date | 2008-02-15 |
Last Update Date | 2019-04-18 |