NPI | 1992176317 |
---|---|
Former Name | LORIANN GIOVANNIELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059784) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C50001215) |
363AM0700X Physician Assistant, Medical (Licence: VA 0110-005120) | |
Enumeration Date | 2015-10-12 |
Last Update Date | 2018-05-23 |