| NPI | 1588631469 |
|---|---|
| Former Name | ANNE VANDERBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 001876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001876) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2014-12-19 |