NPI | 1316191851 |
---|---|
Former Name | ABBY LYNN GOLDBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004646) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053669) |
Enumeration Date | 2008-11-11 |
Last Update Date | 2018-10-19 |