| NPI | 1992790638 |
|---|---|
| Former Name | JEANINE MARIE GEMBALA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-001804) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000783A) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-03-29 |