NPI | 1528195260 |
---|---|
Former Name | KATHLEEN BRIDGET GUYDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 011751) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011751-1) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2015-07-29 |