| NPI | 1558034157 |
|---|---|
| Former Name | COURTNEY ALYSSA FLOTTERON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 026720) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 26720) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-07-17 |