| NPI | 1457628471 |
|---|---|
| Former Name | HEATHER EDMUNDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015044) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000781) |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2021-03-25 |