| NPI | 1255582516 |
|---|---|
| Former Name | COURTNEY LEE ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012856) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055386) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2016-05-02 |