NPI | 1497152318 |
---|---|
Former Name | ELIZABETH AUGUSTA ROSAMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
363AM0700X Physician Assistant, Medical | |
363A00000X Physician Assistant | |
Enumeration Date | 2014-11-20 |
Last Update Date | 2024-12-11 |