NPI | 1508246604 |
---|---|
Former Name | EMILY ELIZABETH ROZWOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006083) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018652) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2015-06-03 |
Last Update Date | 2025-07-29 |