NPI | 1376860098 |
---|---|
Former Name | EMILY J BURGUN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000922) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004221) |
Enumeration Date | 2010-04-21 |
Last Update Date | 2014-02-19 |