NPI | 1376970350 |
---|---|
Former Name | ANNE SANFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1645) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: NY 016942) | |
Enumeration Date | 2013-10-04 |
Last Update Date | 2023-03-22 |