NPI | 1548454820 |
---|---|
Former Name | BRYN FURLONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004495) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY MF1392430) |
Enumeration Date | 2007-08-30 |
Last Update Date | 2016-08-10 |