NPI | 1972051191 |
---|---|
Former Name | TERESA MARGARET SIFFERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06733) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06733) |
Enumeration Date | 2016-09-16 |
Last Update Date | 2020-09-02 |