NPI | 1952335531 |
---|---|
Former Name | DANIELLE DECILLIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00005500) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00005500) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2024-01-23 |