NPI | 1316204472 |
---|---|
Former Name | ROXANNE ADIL GANDHY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002739) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002739) |
363AS0400X Physician Assistant, Surgical (Licence: CT 002739) | |
Enumeration Date | 2012-04-13 |
Last Update Date | 2013-05-14 |