NPI | 1992058127 |
---|---|
Former Name | CATHLEEN RAIMONDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5289) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI Pending) |
363A00000X Physician Assistant (Licence: MI 5601011729) | |
Enumeration Date | 2012-10-25 |
Last Update Date | 2025-03-06 |