NPI | 1992351415 |
---|---|
Former Name | CERA BLUNK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062121) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005524) |
Enumeration Date | 2019-08-12 |
Last Update Date | 2024-02-27 |