| NPI | 1598263618 |
|---|---|
| Former Name | MOLLY ROZEBOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 5060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006487) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2021-03-19 |