| NPI | 1104176262 |
|---|---|
| Former Name | ASHLEY L. LUSTGARTEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004508) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2021-09-16 |