| NPI | 1942610464 |
|---|---|
| Former Name | ASCHALEW KOCHITO GEBRESILASSIE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001599) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 791125) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-12-06 |