| NPI | 1235602533 |
|---|---|
| Former Name | ANN ELIZABETH DEN HARTOG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |