| NPI | 1104958909 |
|---|---|
| Former Name | AVIVA ROSENBLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011742) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 029400) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2013-10-02 |