NPI | 1992058127 |
---|---|
Former Name | CATHLEEN RAIMONDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 0001) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ Pending) |
363A00000X Physician Assistant (Licence: WI Pending) | |
363A00000X Physician Assistant (Licence: MI Pending) | |
Enumeration Date | 2012-10-25 |
Last Update Date | 2024-02-28 |