| NPI | 1184715260 |
|---|---|
| Former Name | CAROL JUBIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 002877) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA001333L) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-01-08 |