| NPI | 1427678366 |
|---|---|
| Former Name | SYDNEY ROSE LIEFFORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13667) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2021-05-11 |