NPI | 1972384535 |
---|---|
Former Name | MEDINA METJAIC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119959) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030831) |
Enumeration Date | 2023-10-10 |
Last Update Date | 2025-07-02 |