| NPI | 1972872547 |
|---|---|
| Former Name | AFSANAH SUSSAN SALLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110003763) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2023-09-26 |