| NPI | 1003285552 |
|---|---|
| Former Name | ASHLEY LYN NEISEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021113) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 021113-1) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2019-11-06 |