| NPI | 1497152318 |
|---|---|
| Former Name | ELIZABETH AUGUSTA ROSAMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2019-02-25 |