NPI | 1982185328 |
---|---|
Former Name | MONICA ELLEN STASSI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12776) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 12776) |
Enumeration Date | 2018-08-23 |
Last Update Date | 2020-11-10 |