| NPI | 1508246604 |
|---|---|
| Former Name | EMILY ELIZABETH ROZWOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018652) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2017-07-10 |