NPI | 1104160753 |
---|---|
Former Name | LYDIE-DANIELLE SAMEDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00345300) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016255) |
Enumeration Date | 2012-11-20 |
Last Update Date | 2021-05-17 |